: This U10 proposal, RUPP-PI in Pittsburgh is to establish an NIMH Research Unit for Pediatric Psychopharmacology-Psychosocial Intervention in Pittsburgh. The proposed unit builds on the strengths of the Pittsburgh site in clinical epidemiology of mood disorders and suicidal behavior, psychosocial treatment development, pharmacokinetics of SSRI's, and participation in numerous success- fully performed, single and multi-site clinical trials involving CBT, antidepressants, and their combination for mood and anxiety disorders. Resources to support this program of research and training include a T32 postdoctoral training grant in child psychiatry research, an Intervention Research Center on early-onset mood and anxiety disorders, a RUPP devoted to pharmacokinetics of antidepressants, and a state-supported specialty clinic for mood disorders and suicidal behavior. The exemplar research protocol, "Treatment of Adolescent Suicide Attempters" (TASA), targets a major public health issue: although adolescents in this country suffer 2 million suicide attempts annually, no large scale, multimodal controlled intervention studies for this condition have been conducted. The proposed 5-year study will determine the effectiveness of a multi-modal treatment intervention to prevent further reattempts in 480 depressed adolescents attempters, ages 12 to 18, at 8 sites. The Experimental Treatment Group will receive a 24-week course of antidepressant medication management (MM), and cognitive behavioral therapy. The Control Treatment Group will be referred to a community provider for standard clinical care plus enhanced clinical monitoring and case management to encourage treatment adherence. Both groups will be assessed at baseline 2, 4, 8, 12, 24, 36 and 48 weeks by an independent evaluator blind to treatment assignment. We hypothesize that the experimental treatment will result in fewer suicide attempts, diminished depression and severity of suicidal ideation, and greater global improvement scores differ between the 2 groups over a one-year period of observation. The expertise and experience at this RUPP-PI site also will be directed to train new investigators. In creating TASA, a collaborative group of 8 applicants forged the ability to work together.